Adjustable suture technique for enhanced transposition surgery for extraocular muscles

Phamonvaechavan, Pittaya; Anwar, Didar S; Guyton, David L.

doi:10.1016/j.jaapos.2010.08.004

Cited by 21 publications

(44 citation statements)

References 26 publications

(35 reference statements)

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“…4,11 Our success rate was 76%. Armenia, 7 Fitzsimons, 5 and Leiba et al 12 performed unaugmented VRT with intraoperative Eye BTA and gained 60, 50, and 59% success rates, respectively.…”

Section: Discussionmentioning

confidence: 69%

“…[4][5][6][7]12,13 In the current study, mean abduction deficit improved from − 4.4 to − 1.8, which seems to be slightly better than most of previously-mentioned transposition procedures. [4][5][6][7]11 Four (13.7%) of our patients were overcorrected. In all these patients, preoperation esotropia was ≤ 45.…”

Section: Discussionmentioning

confidence: 99%

“…Also, anatomical differences between SR and IR may have a role. Some methods suggested to prevent this complication include adjustable suture technique, 11 intraoperative monitoring of torsion, 16 and modification of Foster technique using single posterior fixation suture. 17 Ruth et al 18 performed vertical forced ductions at the end of procedures to ensure there are no vertical restrictions.…”

Section: Discussionmentioning

confidence: 99%

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Augmented vertical recti transposition with intraoperative botulinum toxin for complete and chronic sixth nerve palsy

Nabie

Andalib

2016

Eye

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Purpose To evaluate the results of augmented vertical rectus muscle transposition (VRT) with intraoperative botulinum toxin (BTX) for complete and chronic sixth nerve palsy. Methods During a 10-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) all patients with chronic and complete sixth nerve palsy and contracted medial rectus (MR) who underwent augmented VRT and BTX injection into the MR enrolled in this study. Results In total, 29 patients (5 bilateral) were enrolled in this study. Preoperative deviation was 45 ± 17.5 Prism Diopter (PD), which was improved to − 3.1 ± 13.2 after the operation (Po0.001). Mean preoperative and postoperative abduction limitation was − 4.4 ± 1.1 and − 1.8 ± 0.9, respectively (Po0.001). The success rate was 76% (deviation within 10 PD of orthotropia). Four patients (13.7%) had hypotropia. In 19 patients with preoperative deviation ≤ 45 PD, four patients had consecutive exotropia. Conclusion Intraoperative BTX injection with augmented vertical rectus transposition is an effective procedure. In deviation ≤ 45 there is a risk of overcorrection.

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“…4,11 Our success rate was 76%. Armenia, 7 Fitzsimons, 5 and Leiba et al 12 performed unaugmented VRT with intraoperative Eye BTA and gained 60, 50, and 59% success rates, respectively.…”

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Augmented vertical recti transposition with intraoperative botulinum toxin for complete and chronic sixth nerve palsy

Nabie

Andalib

2016

Eye

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“…20 In the crossed-adjustable technique described by Phamonvaechavan et al for abducens palsy, simultaneous medial rectus weakening was needed less (37%) than in the conventional transposition group (83%). 15 Recently, Mehendale et al have shown the surgical option of superior rectus transposition alone combined with medial rectus recession to have reduced a mean esotropia of 44Δ to 10Δ in patients with Duane syndrome and abducens palsy. 21 In our patients, the mean preoperative deviation was 30.6 Δ with a postoperative correction of 33.3Δ and a final correction of 20.0Δ.…”

Section: Discussionmentioning

confidence: 99%

“…4 Many modifications of VRT have been proposed over the years, in order to reduce important complications such as anterior segment ischemia, scleral perforation, overcorrections, and induced vertical deviations. [5][6][7][8][9][10][11][12][13][14][15] Adjustable VRT was first described by Carlson and Jampolsky, who proposed a technique of union of the transposed halves of the vertical muscles to permit self-adjustment of the vertical axis and allow for postoperative horizontal adjustment. 7 Laby and Rosenbaum later described an adjustable suture technique for postoperative adjustment of induced vertical deviations or overcorrection.…”

Section: Introductionmentioning

confidence: 99%

Adjustable augmented rectus muscle transposition surgery with or without ciliary vessel-sparing for abduction deficiencies

Hendler¹,

Pineles²,

Velez³

et al. 2013

Journal of American Association for Pediatric Ophthalmology and

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Superior Rectus Transposition and Medial Rectus Recession for Duane Syndrome and Sixth Nerve Palsy

Mehendale¹

2012

Arch Ophthalmol

109

126

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To describe our results using augmented temporal superior rectus transposition (SRT) with adjustable medial rectus muscle recession (MRc) for treatment of Duane syndrome and sixth nerve palsy.Methods: Retrospective surgical case review of patients undergoing SRT. Preoperative and postoperative orthoptic measurements were recorded. Minimum follow-up was 6 weeks. Main outcome measures included the angle of esotropia in the primary position and the angle of head turn. Secondary outcomes included duction limitation, stereopsis, and new vertical deviations.Results: The review identified 17 patients: 10 with Duane syndrome and 7 with sixth nerve palsy. Combining SRT with MRc improved esotropia from 44 to 10 prism diopters (P Ͻ .001), reduced abduction limitation from −4.3 to −2.7 (P Ͻ.001), and improved compensatory head posture from 28°to 4°(P Ͻ .001). Stereopsis was recovered in 8 patients (P =.03). Three patients required a reoperation: 1 for overcorrection and 2 for undercorrection. A new primary position vertical deviation was observed in 2 patients with complex sixth nerve palsy and none with Duane syndrome. No patient described torsional diplopia.Conclusions: Superior rectus transposition allows for the option of simultaneous MRc in patients with severe abduction imitation who require transposition surgery. Combining SRT and MRc improved esotropia, head position, abduction limitation, and stereopsis without inducing torsional diplopia.

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Adjustable suture technique for enhanced transposition surgery for extraocular muscles

Cited by 21 publications

References 26 publications

Augmented vertical recti transposition with intraoperative botulinum toxin for complete and chronic sixth nerve palsy

Augmented vertical recti transposition with intraoperative botulinum toxin for complete and chronic sixth nerve palsy

Adjustable augmented rectus muscle transposition surgery with or without ciliary vessel-sparing for abduction deficiencies

Superior Rectus Transposition and Medial Rectus Recession for Duane Syndrome and Sixth Nerve Palsy

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